Rhomboid Intercostal Block Versus Retrolaminar Block for Postoperative Analgesia After Thoracoscopic Sympathectomy

Ultrasound-guided Rhomboid Intercostal Block Versus Retrolaminar Block for Postoperative Analgesia After Thoracoscopic Sympathectomy: A Randomized Clinical Trial

Background: Although thoracoscopic sympathectomy is made via small incisions, it is associated with severe postoperative pain. Both Rhomboid intercostal block (RIB) and Retrolaminar block (RLB) are recent techniques used for pain control after such procedures

Objectives: To compare the effectiveness of RIB and RLB in providing postoperative analgesia after thoracoscopic sympathectomy in adult patients and their impact on the patient's outcomes.

Patients and Methods: This prospective, randomized (1:1), double-blind clinical trial; will be carried out on 60 patients scheduled for elective thoracoscopic sympathectomy under general anesthesia at our hospital. Patients will be randomly allocated into two equal groups (30 patients each) and will receive: in group A; general anesthesia with intraoperative ipsilateral ultrasound-guided RIB, whereas in group B; general anesthesia with intraoperative ipsilateral ultrasound-guided RLB.

Inclusion Criteria:

• American Society of Anesthesiologists (ASA) physical status ≤ II
• Age from 18 to 60 years
• Body Mass Index (BMI) < 35 kg/m²

Exclusion Criteria:

• American Society of Anesthesiologists (ASA) physical status > II
• Age < 18 years or > 60 years
• Body Mass Index (BMI) ≥ 35
• Local infection at the puncture site
• Altered mental status
• Pregnant women
• Allergy to study drugs
• Chronic pain
• Coagulation abnormalities or on anticoagulants
• Severe hepatic or kidney disease